红外线耳后照射联合曲安奈德耳后注射治疗急性耳鸣的疗效分析

Efficacy of infrared retroauricular irradiation combined with retroauricular injection of triamcinolone acetonide in treatment of acute tinnitus

目的 探讨红外线耳后照射联合曲安奈德耳后注射治疗急性耳鸣的临床疗效。方法 选择在中国人民武装警察部队云南总队医院诊治的急性耳鸣患者93例(159耳),按随机数字表法分为3组,红外照射组(31例54耳)用红外线耳后照射,耳后注射组(30例52耳)用曲安奈德耳后注射,联合组(32例53耳)红外线耳后照射联合曲安奈德耳后注射;所有患者口服甲钴胺0.5 mg/次,3次/d,金纳多银杏叶粉提取物2片/次,3次/d,并给予心理疏导和健康教育辅助治疗;3组均治疗15 d。比较治疗结束时及治疗后30 d,3组患者的临床有效率,测评并比较耳鸣响度、耳鸣意识占比、耳鸣残疾量表(THI)、匹兹堡睡眠质量指数量表(PSQI)的评分;比较不良反应的发生情况。结果 治疗结束后3组临床有效率分别为62.96%、71.15%、84.90%,相比其他两组,联合组有效率显著升高,差异有统计学意义(P<0.05);治疗后30 d 3组临床有效率分别为61.51%、67.30%、81.13%,相比其他两组,联合组有效率仍显著升高,差异有统计学意义(P<0.05)。治疗结束时和治疗后30 d,联合组与其他两组耳鸣响度、耳鸣意识占比、THI、PSQI评分比较,差异均有统计学意义(均P<0.05)。3组不良反应发生率比较,差异均无统计学差异(均P>0.05)。结论 红外线耳后照射联合曲安奈德耳后注射治疗急性耳鸣有较好的临床疗效,安全性较高,值得临床推荐。

Objective To investigate the clinical efficacy of infrared retroauricular irradiation combined with retroauricular injection of triamcinolone acetonide in the treatment of acute tinnitus.Methods Ninety three patients(159 ears) with acute tinnitus treated in Yunnan Provincial Corps Hospital of PAPF were randomly divided into 3 group.All patients were given oral administration of mecobalamin and Ginkgo biloba extract powder,and psychological counseling and health education.In addition,31 cases(54 ears) in group A received infrared retroauricular irradiation;30 cases(52 ears) in group B received retroauricularly injected with triamcinolone acetonide;32 cases(53 ears) in group C received infrared retroauricular irradiation and retroauricular injection of triamcinolone acetonide;all three groups were treated for 15 days.The clinical effective rates of the three groups were compared at the end of treatment and 30 days after treatment,and the scores of tinnitus loudness,propotion of tinnitus consciousness,tinnitus handicap inventory(THI) and Pittsburgh sleep quality index(PSQI) were evaluated and compared.The occurrence of adverse reactions was also compare among three groups.Results The effective rates at the end of treatment in group C were significantly higher than those in group A and group B(84.90% vs.62.96% and 71.15%,P<0.05).30 days after treatment the effective rate in group C was still significantly higher than those in group A and group B(81.13% vs.61.51% and 67.30%,P<0.05).There were significant differences in the scores of tinnitus loudness,propotion of tinnitus consciousness,THI and PSQI among three groups both at the end of treatment and 30 days after treatment(all P<0.05).There was no significant difference in the occurrence of adverse reactions among three groups(P>0.05).Conclusion Infrared retroauricular irradiation combined with retroauricular injection of triamcinolone acetonide has good clinical efficacy and high safety in the treatment of acute tinnitus,which is worthy of clinical recommendation.